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J Korean Acad Rehabil Med. 2004 Oct;28(5):412-417. Korean. Original Article.
Jang SH , Son SM , Ahn SH , Cho SH , Jang HW , Cho YW , Yang DS , Lee DG .
Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Korea.
Department of Physical Therapy, Yonsei University College of Health Science, Korea.
Department of Diagnostic Radiology, Yeungnam University College of Medicine, Korea.

OBJECTIVE: The aim of this study was to elucidate how the location of cerebral infarct influences cortical recovery pattern in hemiparetic stroke patients. METHOD: Forty-three chronic stroke patients and 21 control subjects were recruited for the study. The patients were classified into 4 groups according to infarct locations: cortex (CO), corona radiata (CR), posterior limb of the internal capsule (PL), and brainstem (BS). Functional MRI was performed using the blood oxygen level-dependent technique at 1.5 T with the motor task of hand grasp-release movements. RESULTS: The activation pattern of the primary sensori-motor cortex (SM1) was found to be significantly influenced by the lesion locations, but that of the secondary motor area was not (Pearson's chi-square test, p<0.05). The contralateral' SM1 activation was the major response in the control group (85.7%) and in the BS group (75.0%). On the other hand, the major activation pattern was `peri-lesional' in the CO group (peri-lesional 57.1%, peri-lesional and ipsilateral 42.9%), `bilateral activation' in the CR (85.7%) and the PL group (100.0%). CONCLUSION: Our results suggested that motor recovery mechanisms could be different according to location of cerebral infarct.

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